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A study of one patient suggested that following a specific paleolithic diet—the paleolithic ketogenic diet—led to some improvements in bilirubin levels. However, this has not been confirmed by other research.

Choosing a healthy lifestyle with healthful food and plenty of exercise can help.

Exercise can also help manage stress, reducing the risk of a flareup. Alcohol can make the condition worse.

Causes

A person is born with Gilbert syndrome, when the gene is passed on from a parent, or parents. An individual is more likely to have it if both parents pass on the gene.

The gene causes hyperbilirubinemia, or elevated blood levels of bilirubin.

This happens because of reduced activity by the enzyme glucuronyltransferase, which conjugates, or converts, bilirubin to a water-soluble form after it is released from red blood cells at the end of their 120-day life span.

When the bilirubin becomes water-soluble, the body excretes it in the bile into the duodenum and eventually out of the body in the stool.

Diagnosis

A blood test can detect whether bilirubin levels are higher than usual.

Persons with Gilbert syndrome are usually diagnosed in their late teens or early twenties.

Diagnosis based on the presence of mildly elevated conjugated bilirubin levels in the blood and the proper clinical situation.

Genetic testing is usually not required.

Diagnosis can be confirmed by giving phenobarbital, which lowers bilirubin levels, and intravenous nicotinic acid, which will raise bilirubin levels.

The elevated bilirubin level is usually noticed either in routine lab tests in patients who have no symptoms, or when a liver profile is ordered because the patient has jaundice.

If test results show that water-insoluble bilirubin levels are high, but other tests are normal, Gilbert's syndrome is the most likely diagnosis.

A doctor may want to do further tests to make sure the patient does not have another cause of elevated bilirubin. Some of the other causes are more serious than others.

Gilbert's syndrome does not need treatment, but, again, it is important to make sure that the person does not have another, more serious, condition.

Other reasons why bilirubin levels might be high

Other causes of elevated bilirubin include:

Acute inflammation of the liver: Thich could be related to viral infection, prescription drugs, alcohol, or fatty liver.

Inflammation or infection of the bile duct: This is known as cholangitis, and it can be serious,

Obstruction of the bile duct: Usually related to gallstones but can be related to gallbladder or bile duct cancer or pancreatic cancer.

Cholestasis: The flow of bile from the liver is interrupted, and bilirubin remains in the liver. This can occur with acute or chronic liver inflammation as well as liver cancer.

Crigler-Najjar syndrome: This inherited condition impairs the specific enzyme responsible for processing bilirubin, resulting in an excess of bilirubin.

Dubin-Johnson syndrome: an inherited form of chronic jaundice that prevents conjugated bilirubin from being secreted out of the liver's cells.

Pseudojaundice: a harmless form of jaundice in which the yellowing of the skin results from an excess of beta-carotene, not from an excess of bilirubin; usually from eating lots of carrots, pumpkin, or melon.

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